1. Field of the Invention
The present invention pertains to surgical instruments for accessing cavities within the body and, more particularly, to surgical instruments for establishing communication with an anatomical cavity via insertion in a cavity wall.
2. Discussion of the Prior Art
Surgical penetrating instruments are widely used in surgical procedures to gain access to anatomical cavities ranging in size from the abdomen to small blood vessels, such as veins and arteries, epidural, plural and subachroniad spaces, heart ventricles and spinal and synovial cavities. Surgical penetrating instruments having a penetrating member and a portal sleeve have become extremely popular for use in establishing an endoscopic portal for many various procedures, most notably laproscopic procedures, with access to an anatomical cavity being established via the portal sleeve positioned to extend through a wall of the cavity upon penetration into the cavity by the penetrating member. Once the portal sleeve extends through the thickness of the cavity wall and projects into the cavity, it is desirable to stabilize or secure the portal sleeve in the cavity wall to prevent withdrawal or backing out of the portal sleeve from the cavity. With the portal sleeve secured relative to the cavity wall, insufflation of the cavity via the portal sleeve can be accomplished with greater safety, deflation of the cavity due to backing out of the portal sleeve can be prevented and, when several portal sleeves are utilized, instruments can be inserted via the portal sleeves without colliding in the cavity. In addition to portal sleeves, essentially solid members, such as uterine manipulators, are inserted in anatomical cavities via an opening therein for many surgical procedures; and, frequently, it is desirable to stabilize or lock the members in position to remain in the cavity during the surgical procedures without backing out therefrom.
Stabilizing devices including inflatable balloons or membranes for contacting, in an expanded state, an internal surface of tissue of a cavity wall and having bearing discs for contacting an external surface of the tissue have been proposed to secure surgical instruments relative to the cavity wall, and U.S. Pat. Nos. 5,002,557 to Hasson, 4,077,412 to Moosun, 3,459,175 to Miller and 3,253,594 to Matthews et al are illustrative of such devices. Additionally, portal sleeves having a spiral thread for engaging tissue of a cavity wall to prevent the portal sleeves from slipping out of the cavity after penetration by a trocar have been proposed, and exemplary portal sleeves are disclosed in U.S. Pat. No. 5,009,643 to Reich et al and sold by Storz Surgical Instruments as the Havlicek Trocar and Spiral Cannula.
Prior art stabilizers possess many disadvantages including difficulty in deploying the stabilizers during use, requiring a large contact area with the internal and external surfaces of tissue of a cavity wall, being immovably mounted on instruments to be stabilized such that the instruments must be secured in tissue at a fixed position along the instruments, increased trauma to tissue of the cavity wall, inability to reposition the portal sleeves once the stabilizers have been deployed, jamming and trapping of tissue in the stabilizers and, when inflatable balloons and membranes are utilized, susceptibility to failure due to accidental puncture prior to and during use.